Translational therapies for malignant pleural mesothelioma

Our plain-English summary of Translational therapies for malignant pleural mesothelioma, by C. Belli, S. Anand, G. Tassi, et al (Expert Review of Respiratory Medicine, 2010).

The study

• Authors: C. Belli, S. Anand, G. Tassi, D. Fennell, L. Mutti
• Journal: Expert Review of Respiratory Medicine
• Published: 2010;4(2):249-60
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma is a highly invasive tumor arising from the mesothelial cells of serosal surfaces. Several chemotherapeutic agents have been tested for the treatment of this disease and doublet cisplatin with antifolates has been demonstrated to have significant efficacy in Phase III studies. However, the benefit of these treatments remains poor and the median survival time of patients is low, ranging between 9 and 17 months. Targeted therapies are being developed in oncology and emerging evidence suggests that they offer disease control in several tumors. This article reviews the knowledge on the malignant pleural mesothelioma molecular pathway and focuses on results of clinical trials conducted on this devastating disease.

In plain English

This article was a review, not an original study. The authors summarized laboratory research on the genetic and molecular abnormalities found in malignant pleural mesothelioma, and the results of clinical trials of 'targeted' drugs aimed at those abnormalities. The article noted that the disease is increasing worldwide because of widespread asbestos exposure, but it did not study asbestos exposure itself. Among the trials it described was a Phase III trial of cisplatin plus pemetrexed, a combination the review says was evaluated in 226 patients. That trial reported overall survival of 12.1 months with the combination versus 9.3 months with cisplatin alone. A trial comparing cisplatin plus raltitrexed with cisplatin alone in 205 patients reported median overall survival of 11.4 versus 8.8 months. In a Phase II trial in 108 patients, progression-free survival was 6.9 months when bevacizumab was added to chemotherapy and 6.0 months with placebo (p = 0.88). The authors judged that drugs blocking EGF receptor, PDGF receptor or multiple targets, used alone, did not give a significant benefit. The authors concluded that combining such drugs with chemotherapy seemed a promising direction for research. They added that biomarkers will presumably help identify patients likely to benefit.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of laboratory research and clinical trials of targeted therapies for malignant pleural mesothelioma
• Who was studied: No original study population. The review covered previously published clinical trials (mostly Phase II, some Phase III) and laboratory studies of malignant pleural mesothelioma.
• Exposure: Not an exposure study. Asbestos exposure is mentioned only as the reason the disease is increasing. The review is about drug treatments: chemotherapy and targeted agents such as bevacizumab, sunitinib, vatalanib, sorafenib, thalidomide, imatinib, gefitinib and erlotinib.
• Main results:
  • Cited Phase III trial: the review says the combination of cisplatin and pemetrexed was evaluated in 226 patients with malignant pleural mesothelioma. The combination gave overall survival of 12.1 months versus 9.3 months for cisplatin alone (p = 0.02).
  • Cited EORTC trial (205 previously untreated patients): cisplatin plus raltitrexed gave median overall survival of 11.4 months versus 8.8 months for cisplatin alone (p = 0.048).
  • Cited Phase II trial (108 patients): bevacizumab added to gemcitabine and cisplatin gave progression-free survival of 6.9 months, versus 6.0 months for placebo (hazard ratio 0.93; p = 0.88).
  • The authors' overall reading of the trials was that EGF receptor inhibitors (erlotinib, gefitinib), the PDGF receptor inhibitor imatinib and multitargeted agents (sorafenib, sunitinib, vatalanib) did not give a significant benefit when used as single agents.
• The authors' conclusion: The authors concluded that combining these targeted agents with chemotherapy seems a promising direction for future research. They also concluded that serum or tissue biomarkers will presumably help identify the subset of patients who benefit from targeted drugs.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Mesothelial Cells, Serosal Surface, Cisplatin, Antifolate, Median Survival, Clinical Trial.

Related studies

• Anti-angiogenic therapies for malignant pleural mesothelioma — G.L. Ceresoli, P.A. Zucali (2012)
• Novel targeted therapies and vaccination strategies for mesothelioma — M. Bagia, A.K. Nowak (2011)
• Targeted therapies in malignant pleural mesothelioma: a review of clinical studies — L. Greillier, S. Marco, et al. (2011)
• Emerging translational therapies for mesothelioma — H.I. Pass, B.W. Robinson, et al. (1999)
• Molecular targets in malignant pleural mesothelioma treatment — G. Pasello, A. Favaretto (2009)
• Systemic approach to malignant pleural mesothelioma: what news of chemotherapy, targeted agents and immunotherapy? — D. Signorelli, M. Macerelli, et al. (2016)

Browse more research in Expert Review of Respiratory Medicine, or return to medical research.